Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam.
Clin Microbiol Infect. 2021 Oct;27(10):1515.e1-1515.e8. doi: 10.1016/j.cmi.2021.01.006. Epub 2021 Jan 18.
We performed a One Health surveillance in Hanoi-a region with a high-density human population and livestock production, and a recognized hotspot of animal-associated antimicrobial resistance (AMR)-to study the contribution of bla-carrying Escherichia coli and plasmids from food-animal sources in causing human community-acquired urinary tract infections (CA-UTIs).
During 2014-2015, 9090 samples were collected from CA-UTI patients (urine, n = 8564), pigs/chickens from farms and slaughterhouses (faeces, carcasses, n = 448), and from the slaughterhouse environment (surface swabs, water, n = 78). E. coli was identified in 2084 samples. Extended-spectrum β-lactamase (ESBL) production was confirmed in 235 and bla in 198 strains by PCR with short-read plasmid sequencing. Fourteen strains were long-read sequenced to enable plasmid reconstruction.
The majority of the ESBL-producing E. coli strains harboured bla (n = 198/235, 84%). High clonal diversity (48 sequence types, STs) and distinct, dominant STs in human sources (ST1193, n = 38/137; ST131, n = 30/137) and non-human sources (ST155, n = 25/61) indicated lack of clonal transmission between habitats. Eight bla variants were identified; five were present in at least two sample sources. Human and food-animal strains did not show similar plasmids carrying shared bla genes. However, IS6 elements flanking ISEcp1-bla-orf477/IS903B structures were common across habitats.
In this study, animal-associated blaE. coli strains or bla plasmids were not direct sources of CA-UTIs or ESBL resistance in humans, respectively, suggesting evolutionary bottlenecks to their adaptation to a new host species. Presence of common IS6 elements flanking bla variants in different plasmid backbones, however, highlighted the potential of these transposable elements for AMR transmission either within or across habitats.
我们在河内进行了一项健康一体化监测——该地区人口密度高,畜牧业发达,并且是公认的动物相关抗生素耐药性(AMR)热点地区——以研究食源动物携带 bla 的大肠杆菌和质粒对引起人类社区获得性尿路感染(CA-UTI)的作用。
2014 年至 2015 年,我们从 CA-UTI 患者(尿液,n=8564)、农场和屠宰场的猪/鸡(粪便、尸体,n=448)以及屠宰场环境(表面拭子、水,n=78)中采集了 9090 个样本。从 2084 个样本中鉴定出大肠杆菌。通过 PCR 结合短读质粒测序,确认了 235 株产超广谱β-内酰胺酶(ESBL)和 198 株 bla。对 14 株菌进行了长读测序,以实现质粒重建。
大多数产 ESBL 的大肠杆菌菌株携带 bla(n=198/235,84%)。人类来源(ST1193,n=38/137;ST131,n=30/137)和非人类来源(ST155,n=25/61)中 ESBL 产生的大肠杆菌菌株具有高度的克隆多样性(48 个序列型,ST)和独特的优势 ST,表明生境之间缺乏克隆传播。确定了 8 种 bla 变体,其中 5 种存在于至少两种样本来源中。人类和食源动物菌株携带的 bla 基因并不相同。然而,在不同的生境中,围绕 bla-orf477/IS903B 结构的 IS6 元件是共同存在的。
在本研究中,动物相关 blaE. coli 菌株或 bla 质粒均不是 CA-UTI 或人类 ESBL 耐药的直接来源,这表明它们在适应新宿主物种方面存在进化瓶颈。不同质粒骨架中 bla 变体周围存在共同的 IS6 元件,突出了这些可移动元件在生境内部或生境之间传播 AMR 的潜力。